OrganizationActive
Shopko Stores Operating Co LLC
NPI 1083896716 · Community/Retail Pharmacy · Jackson, MN
Provider details
- NPI number
- 1083896716
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Michael Bettiga, Excutive Vice President & Coo(920) 429-4297
Specialties & taxonomies
Suppliers
- Pharmacy333600000X
Suppliers
Suppliers
Practice location
506 2nd St
Jackson, MN 56143
Phone: (507) 847-2480
Fax: (507) 847-2480
Approximate (ZIP-level) locationGet directions
Mailing address
506 2nd St
Jackson, MN 56143
Other names (DBA / former)
- Doing business as
- Shopko Pharmacy 777
Registry dates
- Enumerated
- 2007-12-05
- Last updated
- 2012-07-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.